The Impact of Surgical Practice on Oncological Outcomes in Robot-Assisted Radical Hysterectomy for Early-Stage Cervical Cancer, Spanish National Registry

This study aimed to assess whether surgical practice had a significant impact on oncological outcomes among women who underwent robot-assisted radical hysterectomy for early-stage cervical cancer (≤IB1 or IIA1, FIGO 2009). The secondary objective was to audit the pre-surgical quality indicators (QI)...

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Detalhes bibliográficos
Autores: Fernández González, Sergi, Ponce, Jordi, Martínez Maestre, María Ángeles, Barahona, Marc, Gómez Hidalgo, Natalia R., Díaz Feijoo, Berta, Casajuana, Andrea, Gracia, Myriam, Frías Gómez, Jon, Benavente, Yolanda, Costas, Laura, Martí, Lola, Melero, Lidia, Silvan, Jose Manuel, Beiro, Eva, Lobo, Ignacio, De la Rosa Fernández, Jesús Hilario, Coronado, Pluvio J., Gil Moreno, Antonio
Tipo de documento: artigo
Data de publicação:2022
País:España
Recursos:Universidad del País Vasco
Repositório:Addi. Archivo Digital para la Docencia y la Investigación
OAI Identifier:oai:addi.ehu.eus:10810/55453
Acesso em linha:http://hdl.handle.net/10810/55453
Access Level:Acceso aberto
Palavra-chave:early-stage cervical cancer
robotic surgery
radical hysterectomy
oncological outcome
recurrence
disease-free survival
surgical practice
surgery
Descrição
Resumo:This study aimed to assess whether surgical practice had a significant impact on oncological outcomes among women who underwent robot-assisted radical hysterectomy for early-stage cervical cancer (≤IB1 or IIA1, FIGO 2009). The secondary objective was to audit the pre-surgical quality indicators (QI) proposed by the European Society of Gynaecological Oncology (ESGO). The top 5 of 10 centers in Spain and Portugal were included in the analysis. The hospitals were divided into group A (n = 118) and group B (n = 97), with recurrence rates of <10% and >10%, respectively. After balancing both groups using the propensity score, the ORs for all events were higher and statistically significant for group B (recurrences OR = 1.23, 95% CI = 1.13–1.15, p-value = 0.001; death OR = 1.10, 95% CI = 1.02–1.18, p-value = 0.012; disease-specific mortality ORr = 1.11, 95% CI = 1.04–1.19, p-value = 0.002). A higher surgical volume, higher participation in clinical trials, higher rate of MRI use for diagnosis, greater use of sentinel lymph node biopsies, and a favorable learning curve with low rates of early recurrences were observed among the centers with better oncological outcomes. These factors might have a significant impact on oncological outcomes not only after robot-assisted surgery, but also after laparoscopies and open surgeries in the treatment of cervical cancer.

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